Hénon H, Pasquier F, Leys D
Department of Neurology, Stroke Unit, Lille University Hospital, Lille, France.
Cerebrovasc Dis. 2006;22(1):61-70. doi: 10.1159/000092923. Epub 2006 Apr 26.
The association between stroke and dementia is frequent. The prevalence of poststroke dementia (PSD) ranges from 6 to 32%, depending on the population studied, the criteria used for the diagnosis of dementia, and the time interval between the stroke and the neuropsychological assessment. The risk of PSD is high immediately after stroke and remains higher than in controls in stroke patients nondemented 3 months after stroke. Not all cases of PSD are vascular in origin, with about one third of demented patients diagnosed as having Alzheimer's disease plus stroke. The pathophysiology of PSD is probably multifactorial, with an influence of vascular lesions, associated Alzheimer's lesions and white matter changes. The risk of dementia is higher in older patients and in patients with preexisting cognitive decline - no dementia, severe stroke, a history of stroke, white matter changes and cerebral atrophy. The influence of stroke location, vascular risk factors and silent infarcts remains to be determined. PSD adversely influences the outcome in stroke patients.
中风与痴呆之间的关联很常见。中风后痴呆（PSD）的患病率在6%至32%之间，这取决于所研究的人群、痴呆诊断所用的标准以及中风与神经心理学评估之间的时间间隔。中风后PSD的风险在中风后立即很高，并且在中风后3个月无痴呆的中风患者中仍高于对照组。并非所有PSD病例都源于血管性因素，约三分之一的痴呆患者被诊断为患有阿尔茨海默病合并中风。PSD的病理生理学可能是多因素的，受血管病变、相关的阿尔茨海默病变和白质变化的影响。老年患者以及已有认知功能减退（无痴呆）、严重中风、中风病史、白质变化和脑萎缩的患者患痴呆的风险更高。中风部位、血管危险因素和无症状梗死的影响尚待确定。PSD对中风患者的预后有不利影响。
